title: Sensitivity of MRI of the spine compared with CT myelography in orthostatic headache with CSF leak.
abstract: OBJECTIVE
  To investigate the sensitivity of MRI of the spine compared with CT myelography (CTM) in detecting CSF leaks.
  
  
  METHODS
  Between July 1998 and October 2010, 12 patients with orthostatic headache and a CTM-confirmed spinal CSF leak underwent an MRI of the spine with and without contrast. Using CTM as the gold standard, we retrospectively investigated the sensitivity of spinal MRI in detecting a CSF leak.
  
  
  RESULTS
  Eleven of 12 patients with a CSF leak documented by CTM also had extradural fluid collections on spinal MRI (sensitivity 91.7%). Six patients with extradural fluid collections on spinal MRI also had spinal dural enhancement.
  
  
  CONCLUSIONS
  When compared with the gold standard of CTM, MRI of the spine appears to be a sensitive and less invasive imaging modality for detecting a spinal CSF leak, suggesting that MRI of the spine should be the imaging modality of first choice for the detection of spinal CSF leaks.
authors.affiliation: From the Departments of Neurology (A.S., R.H., B.B.V., E.H., D.D.), Radiology (J.M.H.), and Anesthesiology (T.T.), Mayo Clinic, Phoenix; and Arizona State University (F.H.), Tempe, AZ.
authors.forename: Amaal
authors.initials: A
authors.lastname: Starling
authors.forename: Fatima
authors.initials: F
authors.lastname: Hernandez
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Hoxworth
authors.forename: Terrence
authors.initials: T
authors.lastname: Trentman
authors.forename: Rashmi
authors.initials: R
authors.lastname: Halker
authors.forename: Bert B
authors.initials: BB
authors.lastname: Vargas
authors.forename: Eric
authors.initials: E
authors.lastname: Hastriter
authors.forename: David
authors.initials: D
authors.lastname: Dodick
mesh_terms: D000465:Algorithms; D002559:Cerebrospinal Fluid Rhinorrhea / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D006261:Headache / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009192:Myelography / Q000379:methods*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed